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OCT -13 -2005 16:44 From: <br />THE TERMS AND CONDITIONS I <br />CONSIDF.RATTON. PI RASR RRAD <br />REVIEW TIIE POLICY FORMS M <br />UPON THE S'I'AI'EMEN'IS MAD$ <br />YOUR REQUEST AS FOLLOWS. <br />DATE ISSUED: <br />PRODUCER: <br />INSURED: <br />M& Tc <br />POLICY NO.: <br />QQY03APE: <br />BINDER EFFECTIVE <br />POLICY PERIOD: <br />12:01 A.M. STANDARD "DMF-AT <br />LIMITS OF LIABILITY: <br />$1,000.000 <br />$1,000,000 <br />DEDUCTIBLE: <br />PREMIUM AND FEES: <br />.OINK 1 AN <br />TERMS I CONDITIONS: <br />ENDORSEMENTS/ <br />ALL OTHER TERMS AND <br />INS -SUCS 949 276 5522 To:9496424025 P.1/1 <br />&I-d��5 -�O� <br />CONFIRMATION OF COVERAGE <br />THIS CUNFIRMATION OF INSURANCh MAY NUI' COMPLY WITH 111E SPECIFICA'T'IONS SUHmn-1 i) POR <br />ITS CONFIRMATION CAREFULLY AND COMPARE IT WITH ANY QUOTE AND SUBMISSION DOC'UM01S AND <br />TIIE ACTIIAL COVRRAGFS PROVIDFD.IN ACCORDANCE. WrrH YOUR INSTRUCTIONS, AND IN RELIANCE, <br />'THE IterAll. BROKER IN THE INSUREDS AI'PUCkEON/SUBMISSION. WE HAVE OBTAINED INSURANCE AT <br />Sep 30, 2005 <br />Tasman Ins. & Financial Services <br />3 Sablawood Circle <br />Ladera Ranch CA 92694 <br />Robert Tyler <br />2008 Centella PI <br />Nowport Beach CA 92660 <br />CNA Insurance <br />MCA276195773 <br />Professional LlebiRiy <br />9/29/2005 TO <br />9/29/2005 TO 9129/2006 <br />LOCATION ADDRESS OF THE NAMED INSURED. THIS INSURANCE BINDER WILL BE TERMINATED AND <br />DED UPON DELIVERY OF I H6 FORMAL POLICY(IFS) ISSUFO TO REPLACE IT <br />Per Claim <br />Aggregate Limit <br />$5,000 Per Claim <br />$2,780.00 APPROVED AS TO FORM <br />Laura Stitt Sh dy <br />Assistant City Attorney <br />APPLY PER FORM <br />CANCEI.t.ATION: TI-15 POLICY I SUBJECT TO THE CANCELLATION PROVISIONS AS FOUND IN THE POUCYQEB) OR CERTIFICATES) <br />CURRENTLY IN USE BY THE 'URSH. rHF INSURANCE EFFECTED U DER THE INSURER'S BINDER CAN BE CANCELLED BY THE <br />INSURER (SUBJECT TO SI'ATUT AY REGULATIONS) BY MAIUVINESAFS INSURED AT THE ADDRESS STATED ON THE FACE OF THIS <br />CONFIRMATION OF INSURANCE WRITTEN NOTICE STATING CH CANCELLATION SHALL BE EFFECTIVE, IN THE EVENT OF <br />CANCELLATION RV THE INSUR D, THE EARNED PREMIUM Be SUBJECT TO THE MINIMUM PREMIUM IF APPLICABLE. THIS <br />CONFIRMATION OF INSURANCE S ISSUED BASED UPON ' _ AGREEMENT TO BIND AND IS ISSUED 6Y THE UNDERSIGNED <br />WITHOUT ANY LIABILITY WHA'rS EVER AS AN INSURE <br />